Protracted Chemical Peritonitis Following Laparoscopy for Dermoid Cyst: A management dilemma

Area of Science:

• Gynecology
• Surgical Pathology
• Peritoneal Diseases

Background:

• Dermoid cysts are common benign ovarian neoplasms originating from germ cells.
• Laparoscopic salpingo-oophorectomy is a standard surgical approach for symptomatic ovarian dermoid cysts.

Observation:

• A rare case of chemical peritonitis and prolonged fever occurred post-laparoscopic salpingo-oophorectomy for a large ovarian dermoid cyst with torsion.
• The patient experienced a prolonged hospital stay requiring antibiotics, anti-inflammatory agents, repeated drainage, and re-laparotomy.

Findings:

• Chemical peritonitis following ovarian surgery is an uncommon but serious complication.
• Management is challenging due to limited established protocols and may necessitate multiple interventions.

Implications:

• This case highlights the potential for severe complications even with minimally invasive gynecologic surgery.
• Effective management of chemical peritonitis requires a multidisciplinary approach and potentially prolonged treatment.
• Further research into the pathophysiology and optimal management strategies for this rare complication is warranted.